Dummies April 2006

Excerpt from Arthritis For Dummies

Ten Drug-Free Ways to Fight Arthritis

In This Chapter

• Sleeping comfortably

• Helping yourself with simple diet and lifestyle changes

• Keeping Jack Frost at bay

• Supplementing the benefits

Even though you have arthritis, you can live an active and comfortable life without drugging yourself up to the eyeballs. The following drug-free suggestions can help relieve pain and stiffness and may also help cut back on the number of prescription pills you pop each day.

Mastering Your Mattress

Sleeping on a comfortable mattress can reduce pain and stiffness, but sleeping on a mattress that’s too hard or too soft can make your joint pain worse.
Signs that you may need a new mattress, or even a new bed (an adjustable one, for example) include:

• Tossing and turning at night, trying to get comfortable

• Waking with neck or backache

• Developing tenderness over bony prominences (especially hip or heel) from the pressure of sleeping on these areas

To solve the problem of sleeping (or, more likely, not sleeping) with arthritis pain, many people opt for one labelled as an orthopaedic bed. However, in reality there’s no such thing; orthopaedic beds are just a manufacturer’s name for one that is harder than normal, and this does not suit everyone. Although a firm mattress that evenly supports your weight is a good choice, there is no evidence that the harder the bed, the better - especially as you get older, when it’s important to avoid excess pressure on the bits of you in contact with your mattress during sleep.

Lots of different types of mattress are now available and, when selecting a new mattress or bed, try lying on as many different surfaces as possible, to see which you find most comfortable. Don’t feel embarrassed about asking the salesperson to leave you for 15 minutes to see how the surface suits you – they understand that beds are a very individual thing (and if they don’t they need another job!) And if you sleep with someone, try out the bed together with your partner. If he or she moves, does it disturb you? Is there a tendency for one person to roll towards the other?

Although sleeping surfaces are an individual thing, I believe a memory foam mattress is best for anyone with back pain or osteoarthritis, as it gets you as close to weightless sleeping as possible. The term ‘memory foam’ doesn't mean the mattress remembers the contours of your body, although you can see your dent in the mattress for a few seconds after getting up; it refers to the fact that the foam material remembers its original shape and bounces back into it as soon as you get up. Memory foam is one of the many benefits to come out of the space program. NASA scientists originally developed the material to help astronauts withstand massive G-forces during space flights! These scientists soon realised that the visco-elastic polymer, which is heat and pressure sensitive, forms a perfect sleeping surface that naturally moulds to your body shape.

Unfortunately, memory foam mattresses are relatively expensive, although when you work out the nightly cost of sleeping on one over at least ten years, it doesn’t seem so bad. If your own mattress is serviceable, but uncomfortable, an alternative is a memory foam overlay which goes on top to give firm support as your body sinks into the material. A visco-elastic polymer mattress overlay helps support the natural curves of your back, reduces the load on your pressure points, and helps your muscles and ligaments recover during sleep. Research shows that reducing the strain on your joints also reduces the number of times you toss and turn from the usual average of 80 to 100 times to less than 20 times a night. Improved restlessness means less pain; thus, reducing your need for both sleeping tablets and painkillers. Pillows, seat wedges, and back supports in the same material are also available. Buyers beware – these mattresses are so comfortable you won’t want to get up in the morning!

Taking Regular Exercise

While getting enough rest is important, don’t go overboard and rest all the time! Being inactive makes your muscles weak and increases joint stiffness, while regular exercise helps maintain your joint mobility and muscle strength.
Many people worry that physical activity damages their joints further. Far from it! Do go gently and avoid weight-bearing activities, such as jogging, that place extra strain on your lower limbs. Simple exercises such as walking, cycling, and swimming are best, though do avoid walking on rough ground. Ideally, you can ask a physiotherapist to suggest a regime tailored to your individual needs. Chapter 16 in Arthritis For Dummies –UK Edition has exercises and tips.

Eating Well

Like your heart, your joints thrive best on a healthy diet. Eat plenty of fresh fruit and vegetables - at least five servings per day. Fruit and veg contain antioxidant vitamins such as vitamins A and C, as well as carotenoids and the mineral selenium, which can reduce the rate at which your cartilage breaks down.

Antioxidants help to damp down inflammation and are remarkably effective in slowing the progression of osteoarthritis. In one study of 640 men and women, those with moderate–to-high intakes of vitamin C (two or more times the recommended daily amount) were three times less likely to develop knee pain or to see their knee osteoarthritis worsen than those with low intakes of vitamin C (up to about twice the recommended daily amount). An apple a day really does keep the doctor away – they are rich sources of protective antioxidants called flavonoids. In fact, following a full-blown vegetarian diet appears to have particular benefits for people with rheumatoid arthritis.

If you follow a vegetarian diet, maintaining good intakes of vitamins and minerals, especially of iron, zinc, and vitamin B12, is important as levels of these are often low in non-meat diets.
Eating oily fish such as salmon, trout, sardines, herrings, and mackerel also helps keep your joints healthy by damping down inflammation. Many people choose to take an omega-3 fish oil or cod liver oil supplement.
And if you’re prone to gout, help lower uric acid levels by reducing your intake of purine-rich foods such as offal, shellfish, oily fish, game, meats, yeast-extracts, asparagus, and spinach.
For more dietary info, turn to Chapter 15 of Arthritis For Dummies – UK Edition

Considering Hydrotherapy

For helping ease pain and stiffness, there’s nothing like a warm bath. That’s why hydrotherapy, in which exercise is performed in a warm, deep pool, gives such excellent results. Ask your doctor if a hydrotherapy pool is available in your area – many physiotherapy departments now have them. Chapter 14 of Arthritis For Dummies – UK Edition has more information on hydro and other therapies.

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Losing Excess Weight

If the pounds mount over the years, not only your silhouette suffers. Did you know that when you walk, the load on your lower limbs reaches up to five times your body weight? So, if you’re just 4.5 kilograms (10 pounds) overweight, your legs bear the brunt of an extra 22 kilograms (50 pounds)! Sounds scary, but turn it round the other way and you realise that losing just half a kilogram (or 1 pound) in weight can reduce the strain on your legs to the tune of just over 2 kilograms (5 pounds) per step.
Switch to more fruit, vegetables, and salad stuff, and ditch those pies, pastries, cakes, biscuits and chocolates, which from now on are no more than occasional treats. Sob.

Keeping Warm

Cold is one of the worst culprits for encouraging stiff, aching joints. Get out those woolly jumpers, vests, and long-johns once Jack Frost starts making an appearance. Avoid cold draughts and keep as warm as possible in winter, especially when going out. Wrap up in multiple layers, wear hat, gloves, scarf, and thick socks, and don’t worry about looking unfashionable.
If you have rheumatoid arthritis, try exercising your hands in hot, soapy water first thing in the morning and throughout the day. Frequent hot baths/showers are also soothing. Applying hot compresses or packs that you warm in the microwave (widely available from chemists) are worth trying too. And don’t forget your hot water bottle or electric blanket when it’s time for bed.

If using an electric over- or underblanket, check that it’s in good repair and only use according to instructions.

Wielding a Stick

Using a walking-stick can more than halve the load on weight-bearing joints, and increase your stability and balance - as long as you wield it properly. Think of your stick as a third limb. Use your stick on the opposite side to your worst leg, so if your left hip joint is worse, hold the stick in your right hand, regardless of which hand is dominant. (If both legs are ‘bad’, you may need to use two sticks, crutches, or a walking frame.) First, put all your weight on your ‘good’ leg, then step forward a comfortable distance with your ‘bad’ leg and the stick at the same time. Once your weight is supported on both your stick and your bad leg, step through with your good leg. Sounds simple? You may need practise to overcome the urge to use the walking-stick on the same side as your bad leg.

Select a walking-stick at a height that leaves your elbow slightly bent during use, and try to maintain an upright posture when walking.
If you're experiencing difficulties with walking, ask for a review with an occupational or physiotherapist to select additional aids for you. Tips for walking correctly can be found in Chapter 17 Arthritis For Dummies – UK Edition

Wearing a Copper Bracelet

How copper helps reduce joint pain remains unclear, but is likely to centre on its involvement in the function of a number of antioxidant enzymes, including powerful superoxide dismutase (SOD). Lack of copper reduces activity of SOD and may contribute to the development of inflammatory diseases. Copper is also involved in vitamin C metabolism and the synthesis of collagen – a major structural protein in bones and joints. Another theory is that copper bracelets work through a process known as iontophoresis, in which copper leaches excess sulphates from the body where they are deposited as a blue-green discolouration on the skin. Trace amounts of copper are absorbed through the skin, and in one study of 240 people with rheumatoid arthritis, those wearing copper bracelets had a statistically significant improvement compared to those wearing an inactive, placebo bracelet. Each copper bracelet lost an average of 13 milligrams of copper during the trial. The efficacy of copper bracelets is thought to depend on the level of copper in your body. If you are copper deficient, you may benefit from a bracelet, but if your level is already adequate, it may not help.

Cheaper copper bracelets may contain nickel, to which many people are allergic. If you are sensitive to nickel, only buy a bracelet guaranteed to be nickel free.

Using Magnetic Patches

Applying magnetic patches on tender spots around arthritic joints can ease pain and stiffness quite quickly. A double-blind study in Japan found that magnetic patches were 80 per cent effective in relieving painful, stiff shoulders compared with just 6 per cent for non-magnetised placebo patches. In another double-blind study involving 222 patients with acute and chronic muscle and joint pain, 90 per cent of those using magnetic patches reported significant improvement within five days, compared with only 14 per cent in the placebo group. Chapter 14 of Arthritis For Dummies discusses patches in more depth.

Selecting Supplements

Lots of food supplements have proven anti-inflammatory actions that are at least as effective as those of non-steroidal drugs, but with significantly less risk of serious side effects. Combining these food supplements with physiotherapy and regular exercise can help to reduce pain and improve your mobility if you are unable, or unwilling, to take prescribed treatments. In some studies, supplements given together with prescribed painkillers helped to reduce the dose of drugs needed.

In general, each supplement tends to help around two-out-of-three people, but predicting in advance which supplement suits an individual is difficult. Use trial and error to find those supplements that are best for you. Information on the different supplements you can try is available in Chapters 11 and 15 of Arthritis For Dummies

A common starting point is to take:

• Glucosamine sulphate (with or without chondroitin)

• Omega-3 fish oils

• A multivitamin and mineral, perhaps with extra vitamin C

If you have very inflamed joints, you can also add in anti-inflammatory turmeric, bromelain, Devil’s claw, green-lipped mussel extracts, or MSM sulphur.

Always tell your doctor or pharmacist if you intend to combine supplements with prescribed medication, and check there are no known interactions.

(The above is an extract from Arthritis For Dummies )

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